Outward projections for the surfaces of bone, often seen in people who have done a great deal of swimming in cold water.

Exostoses

T or F
If the EAC is blocked by ear wax, hearing will not be normal even if there is a tiny opening?

False, it will still be normal so long as there is a tiny opening.

Natural cleansing of the EAC can be disrupted if you excessively __________ your ears.

clean

(this can push earwax (cerumen) into the inner 2/3 of the EAC)

What is the leading cause of wax being pushed into the EAC?

Q-tips

Wax deposited in the _______ _______ becomes itchy and dry, causing itching and encourages the indv. to push the wax fruther down while trying to remove it with cotton swabs.

bony canal

Which of the following are used for cerumen removal?
A. Water Irrigation
B. Suction
C. Curettes
D. All of the above

D. All of the above

Ear candling dates back nearly _______ years.

5000

T or F
Ear Candling is suppose to create a partial vacuum to remove earwax?

True

T or F
There is scientific evidence to prove that candling works.

False (also can cause risk of mild and severe burns)

TM perforations are caused by excessive pressure __________, __________, ________ of the TM and the most common of trauma due to perforation.

build-up, infections, necrosis

TM perforations can be caused by this kind of activites?

1. Q-tip

2. Sudden pressure (hands claped over ear)

3. Explosion

____________ perforations spontaneoulsy close better than do perforations resulting from disease.

Traumatic

Perforations in the ___________ portion of the TM heal more rapidly than those in the ___________ portion.

inferior, superior

Surgical repair of a perforated TM?

Myringoplasty

When calcium plaques appear, adding to the mass of the TM and interfering with its vibration.

Tympanosclerosis

When you have a TM perforation, measurements on acoustic immittance are sometimes________ because an airtight seal cannot be formed as a consequence of pressure leakage from the air pump of the meter through the perforation into the middle ear.

impossible

The middle ear is an ___ filled space roughly 2cm3.

air

The _______ of the middle ear is a thin layer of ________ separating the middle-ear cavity from the brain.

roof, bone

The floor of the middle ear contains the _______ _______.

jugular bulb

Behind the anterior wall in the middle ear is the ______ ________.

carotid artery

Behind the medial wall in the middle ear is the _____________.

labyrinth(balance)

Behind the posterior wall in the middle ear is the ___________ ___________.

mastoid process

The middle ear is connected to the _______________.

nasopharynx (back of the throat and nose communicate)

The nasopharynx communicates via the

Eustachian Tube (ET)

The _______, _________, and _______ are all lined with mucous membranes, the same lining found in the nose and paranasal sinuses.

ET, middle ear, TM

Hair-like cells are called

cilia

Mucous membranes contain _______ that use a sweeping motion to clear out debris.

cilia

The Eustachian Tube in normally _________, but is opened by __________ in the nasopharynx.

closed, muscles

Opening of the Eastachian Tube is caused by

yawning, sneezing, swallowing, or excessive air pressure applied to the nose.

In infants, the ET is ________, ________ and more __________ when compared to adults.

shorter, wider and horizontal

The ET remains open in the nasopharynx orifice in infants until the age of _____.

6 months

The air pressure in the middle ear must ________ that of the EAC to keep pressure ________ on both sides of the TM to maximize mobility for optimal sound transmission.

match, equal

The Eustachian tube will lock shut at ________ _________ making pressure equalization impossible.

extreme pressure

The _________ is honeycombed with hundreds of air cells and the cells are lined with __________ membrane similar to the middle ear.

mastoid, mucous membrane

The bony protuberance behind the auricle is the

mastoid process - used for placement of the bone oscillator

What are the two windows in the middle ear?

oval and round windows

________ is filled by a membrane that supports the base of the stapes

Oval Window.

The tiniest bone in the human body is the

stapes

__________ Allows for transmission of sound to be carried out in the middle ear air space

Bones in the middle ear

The bones in the ear are termed?

ossicles

The ossicles are comprised of the

stapes, malleus, incus

The __________ of the malleus is embedded in the middle (fibrous) layer of the TM and extends to the ________ of the TM of the area of greatest retraction (Umbo).

manubrium (handle), center

What is the primary responsibility of the bones of the middle ear?

sound transmission to the inner ear

Sound hits the TM and transfers to the ______ and _______ as they move in an inward outward motion causing them to rotate. The sound is then transferred to the __________ and causes it to move in and out of the oval window.

malleus, incus. stapes

The area of the TM is _____ times that of the oval window. This allows for a sound pressure increase in the middle ear to transfer the presure to the inner ear via the ________ ________.

17, oval window

The increase in pressure in the middle ear is needed due to a transfer of sound from ______ to ________ in the inner ear.

air, fluid

T or F
The TM is a 100% efficient as an impedance matcher?

False it is NOT

Increased pressure and the lever action of the __________ result in a pressure increase of _____ times that of an airborne tranmission alone. Approximatley a ____ dB increase?

malleus, 23 times. 30 dB

A ____ dB loss would result due to the air to fluid impedance mismatch without the ossicles.

28 dB

Contains a portion of the facial nerve(VIIth cranial nerve) and passes through the middle ear via a medial wall.

Fallopian Canal

A branch of the facial nerve.

Chorda Tympani Nerve- get hit in surgery a lot, causes a loss of sensation(metallic taste)

Carries information about the sensation of taset from the anterior 2/3 of one side of the tongue.

Chorda Tympani Nerve

May serve as a minor protection to loud sounds and contraction may also serve to decrease internal sounds such as chewing or speaking.

Middle Ear Muscles

Tendon attaches to the neck of the stapes, may aid in word recognition in noise by attenuating ___ frequency components of the noise.

Stapedius Muscle, low

Inserts in the manubrium of the malleus and contraction may cause the TM to become tense.

Tensor Tympani Muscle

Innervation of the Tensor Tympani is via the ______ _______.

trigeminal nerve (Vth cranial nerve)

Abnormalities of the middle ear produce a __________ hearing loss.

conductive

CHL may show alteration of the ______ conduction thresholds even without sensory/neural involvement.

bone (BC)

The sensory/neural component in ______ hearing losses may be exaggerated by artifacts of bone conduction.

Progression of Suppurative Otitis Media:
As condition worsens, suppurative (pus) like fluid may may accumulate.
Enzymes from the bacteria infection can have a __________ effect on the
middle ear structures.

dissolving

Progression of Suppurative Otitis Media:
Causes -symptoms

pain and fever

Progression of Suppurative Otitis Media:
If the condition progressess the TM will ___________.

rupture

Pus, due to infection, that cannot escape may invade the mastoid causing ___________. Breaks down the wall separtating the air cells and can cause ___________ and sometimes death.

This type of NIHL is perceived when hearing thresholds from initial noise trauma improve over time.

Temporary Threshold Shift (TTS):

This type of NIHL causes an irreversible loss due to noise trauma.

Permanent Threshold Shift (PTS):

Aspirin in combination with NIHL may cause a GREATER shift in temporary hearing sensitivity.

Prevalence of NIHL in children 6-19 years is greater than ___% for boys, and lower than ___% for girls.

14, 10

NIHL in children is possibly due to toy phones, musical instruments, fire crackers, stereo systems and toy guns that produce noise levels up to ___ dBA!

155

Noise-induced hearing loss from impulsive sounds such as explosions and gunfire is known as _____ ______.

Acoustic Trauma

Acoustic Trauma Notch:

hearing is poorest between 3000 and 6000 Hz with recovery at 8000 Hz.

Damage is at those specific frequency regions of the basal end of the cochlea

Millions of dollars each year are spent on military vets due to compensation for NIHL.

Occupational Safety and Health Admin: OSHA

Recommend safety limitations for workers in noisy environments

They state: 85 dBA in an 8 hour work day is acceptable.

For every 5 dB increase, you cut the time in 1/2

The National Institute of Occupational Safety and Health (NIOSH) recommends guidelines that are more stringent than OSHA’s 5 dB step, by using a __ dB exchange rate.

3

This hearing loss is Defined as a decrease of at least 30 dB over at least 3 octaves within a period no greater than 3 days.

Sudden Idiopathic SNHL

Usually unilateral, that may develop over the course of a few days or occur seemingly instantaneously

T or F:
Sudden Idiopathic SNHL is not a medical emergency.

False It Should ALWAYS be treated as a medical emergency.

The quicker the therapy, the more likely the recovery

This disease is caused by an interruption in endolymph volume causing an interruption in the concentration of sodium, chloride, potassium and other electrolytes needed for the system to function normally.